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Cited by 162Wound Healing and TreatmentsImmune cells in cancerMacrophage Migration Inhibitory Factor

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Wound Administration of M2-Polarized Macrophages Does Not Improve Murine Cutaneous Healing Responses

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Jetten, Nadine, Roumans, Nadia, Gijbels, Marion J., Romano, Andrea, Post, Mark J., de Winther, Menno P. J., van der Hulst, Rene R. W. J., Xanthoulea, Sofia·2014·PLoS ONE
DOI 10.1371/journal.pone.0102994PMC PMC4113363
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Abstract

Macrophages play a crucial role in all stages of cutaneous wound healing responses and dysregulation of macrophage function can result in derailed wound repair. The phenotype of macrophages is influenced by the wound microenvironment and evolves during healing from a more pro-inflammatory (M1) profile in early stages, to a less inflammatory pro-healing (M2) phenotype in later stages of repair. The aim of the current study was to investigate the potential of exogenous administration of M2 macrophages to promote wound healing in an experimental mouse model of cutaneous injury. Bone marrow derived macrophages were stimulated in-vitro with IL-4 or IL-10 to obtain two different subsets of M2-polarized cells, M2a or M2c respectively. Polarized macrophages were injected into full-thickness excisional skin wounds of either C57BL/6 or diabetic db/db mice. Control groups were injected with non-polarized (M0) macrophages or saline. Our data indicate that despite M2 macrophages exhibit an anti-inflammatory phenotype in-vitro, they do not improve wound closure in wild type mice while they delay healing in diabetic mice. Examination of wounds on day 15 post-injury indicated delayed re-epithelialization and persistence of neutrophils in M2 macrophage treated diabetic wounds. Therefore, topical application of ex-vivo generated M2 macrophages is not beneficial and contraindicated for cell therapy of skin wounds.

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Figure 1 Visualization of eGFP macrophages in wound tissue. eGFP expressing macrophages were injected in full-thickness excisional skin wounds and tissue was isolated (A) 3 days, (B) 4 days, (C) 6 days and (D) 8 days after injection, and visualized for eGFP expression by fluorescence microscopy.
Figure 1 Visualization of eGFP macrophages in wound tissue. eGFP expressing macrophages were injected in full-thickness excisional skin wounds and tissue was isolated (A) 3 days, (B) 4 days, (C) 6 days and (D) 8 days after injection, and visualized for eGFP expression by fluorescence microscopy.CC BY · PubMed Central
Figure 2 Induction of M2 macrophages. Phenotypic characterization of polarized macrophages. (A) Gene expression analysis for M2 markers in M0 control, M2a and M2c bone marrow derived macrophages (BMDM) after 24 h of IL-4 (for M2a) or IL-10 (for M2c) polarization. (B-D) Gene expression analysis for inflammatory markers in M0 control, M2a and M2c polarized cells after 24 h of polarization and an additional 24 h of LPS stimulation. Cells were analyzed in triplicates and the mean expression of 2–3 independent experiments is indicated. M0 control levels were arbitrarily set to 1 in each experiment and for each gene and statistical significance was evaluated analyzing M2a and M2c expression levels compared to M0, using a one-sample t-test analysis against the hypothetical value 1 (M0). *p≤0.05.
Figure 2 Induction of M2 macrophages. Phenotypic characterization of polarized macrophages. (A) Gene expression analysis for M2 markers in M0 control, M2a and M2c bone marrow derived macrophages (BMDM) after 24 h of IL-4 (for M2a) or IL-10 (for M2c) polarization. (B-D) Gene expression analysis for inflammatory markers in M0 control, M2a and M2c polarized cells after 24 h of polarization and an additional 24 h of LPS stimulation. Cells were analyzed in triplicates and the mean expression of 2–3 independent experiments is indicated. M0 control levels were arbitrarily set to 1 in each experiment and for each gene and statistical significance was evaluated analyzing M2a and M2c expression levels compared to M0, using a one-sample t-test analysis against the hypothetical value 1 (M0). *p≤0.05.CC BY · PubMed Central
Figure 3 Wound healing in M2 macrophage injected wounds generated in C57BL/6 mice. (A) Macroscopic appearance of representative saline, M0, M2a, and M2c injected wounds. Day 0 pictures were taken immediately after wounding. (B) Quantification of wound closure rate. At the indicated days, wound areas were determined using image analysis and expressed as percentage of wound area immediately post-injury as described in methods (n = 6 mice/group). Statistical significance was evaluated with a two-way ANOVA with Bonferroni post-test.
Figure 3 Wound healing in M2 macrophage injected wounds generated in C57BL/6 mice. (A) Macroscopic appearance of representative saline, M0, M2a, and M2c injected wounds. Day 0 pictures were taken immediately after wounding. (B) Quantification of wound closure rate. At the indicated days, wound areas were determined using image analysis and expressed as percentage of wound area immediately post-injury as described in methods (n = 6 mice/group). Statistical significance was evaluated with a two-way ANOVA with Bonferroni post-test.CC BY · PubMed Central
Figure 4 Wound healing in M2 macrophage injected wounds generated in diabetic db/db mice. (A) Macroscopic appearance of representative saline, M0, M2a, and M2c injected wounds. Day 0 pictures were taken immediately after wounding. (B) Quantification of wound closure rate. At the indicated days, wound areas were determined using image analysis and expressed as percentage of wound area immediately post-injury as described in methods (n = 6 mice/group). Statistical significance was evaluated with a two-way ANOVA with Bonferroni post-test. * p<0.05 M0 vs. M2a and M0 vs. M2c. ** p<0.01 saline vs. M2a and saline vs. M2c.
Figure 4 Wound healing in M2 macrophage injected wounds generated in diabetic db/db mice. (A) Macroscopic appearance of representative saline, M0, M2a, and M2c injected wounds. Day 0 pictures were taken immediately after wounding. (B) Quantification of wound closure rate. At the indicated days, wound areas were determined using image analysis and expressed as percentage of wound area immediately post-injury as described in methods (n = 6 mice/group). Statistical significance was evaluated with a two-way ANOVA with Bonferroni post-test. * p<0.05 M0 vs. M2a and M0 vs. M2c. ** p<0.01 saline vs. M2a and saline vs. M2c.CC BY · PubMed Central
Figure 5 Gene expression analysis of db/db wounds isolated at day 15 post-wounding. Wounds were isolated from db/db mice 15 days after wounding and analyzed by real-time PCR for expression levels of (A) macrophage M2 markers Arginase-1, YM-1, Fizz-1 and HMOX-1; (B) inflammatory markers TNF, IL-6, IL-12, IL-1β and IL-10; (C) chemokines CXCL1 and CXCL2 and (D) matrix metalloproteinases MMP2 and MMP9. Statistical significance was evaluated analyzing M0, M2a and M2c expression levels compared to salines by t-test. *p<0.05. n = 6 mice (wounds)/group.
Figure 5 Gene expression analysis of db/db wounds isolated at day 15 post-wounding. Wounds were isolated from db/db mice 15 days after wounding and analyzed by real-time PCR for expression levels of (A) macrophage M2 markers Arginase-1, YM-1, Fizz-1 and HMOX-1; (B) inflammatory markers TNF, IL-6, IL-12, IL-1β and IL-10; (C) chemokines CXCL1 and CXCL2 and (D) matrix metalloproteinases MMP2 and MMP9. Statistical significance was evaluated analyzing M0, M2a and M2c expression levels compared to salines by t-test. *p<0.05. n = 6 mice (wounds)/group.CC BY · PubMed Central
Figure 6 Histological analysis of db/db wounds isolated at day 15 post-wounding. Wounds from saline or macrophage injected db/db mice were isolated 15 days after wounding and processed for generation of paraffin sections. (A-D) H&E stained sections indicating migrating epithelial tongues (dotted line) in M2a and M2c wounds while complete re-epithelialization is present in saline and M0 wounds. (E-H) MSB trichrome staining indicating increased presence of fibrin (marked by arrowheads) and erythrocytes (marked by stars) in M2 macrophage injected wounds. Magnification 40x with 100x insets. Graphs are quantifications of (A) re-epithelialization and (B) fibrin/erythrocyte staining respectively. Statistical significance was evaluated analyzing M0, M2a and M2c expression levels compared to salines by t-test. n = 6 mice (wounds)/group.
Figure 6 Histological analysis of db/db wounds isolated at day 15 post-wounding. Wounds from saline or macrophage injected db/db mice were isolated 15 days after wounding and processed for generation of paraffin sections. (A-D) H&E stained sections indicating migrating epithelial tongues (dotted line) in M2a and M2c wounds while complete re-epithelialization is present in saline and M0 wounds. (E-H) MSB trichrome staining indicating increased presence of fibrin (marked by arrowheads) and erythrocytes (marked by stars) in M2 macrophage injected wounds. Magnification 40x with 100x insets. Graphs are quantifications of (A) re-epithelialization and (B) fibrin/erythrocyte staining respectively. Statistical significance was evaluated analyzing M0, M2a and M2c expression levels compared to salines by t-test. n = 6 mice (wounds)/group.CC BY · PubMed Central
Figure 7 Immunohistochemical analysis of db/db wounds isolated at day 15 post-wounding. Immunohistochemical stainings were performed in cryosections. (A-D) NIMP staining for wound neutrophils indicated higher numbers of neutrophils in M2a and M2c treated wounds compared to saline and M0 groups. Mice analyzed per group: salines = 3; M0 = 5; M2a = 6; M2c = 5. (E-H) F4/80 staining for macrophages indicated not significant differences between the groups. Mice analyzed per group: salines = 4; M0 = 4; M2a = 6; M2c = 6. (I-L) CD31 staining indicated similar staining for endothelial cells in the different groups. Mice analyzed per group: salines = 4; M0 = 5; M2a = 5; M2c = 4. Magnification 40x with 100x insets. Graphs are quantifications of (A) NIMP, (B) F4/80 and (C) angiogenesis staining respectively. Statistical significance was evaluated analyzing M0, M2a and M2c expression levels compared to salines by t-test.
Figure 7 Immunohistochemical analysis of db/db wounds isolated at day 15 post-wounding. Immunohistochemical stainings were performed in cryosections. (A-D) NIMP staining for wound neutrophils indicated higher numbers of neutrophils in M2a and M2c treated wounds compared to saline and M0 groups. Mice analyzed per group: salines = 3; M0 = 5; M2a = 6; M2c = 5. (E-H) F4/80 staining for macrophages indicated not significant differences between the groups. Mice analyzed per group: salines = 4; M0 = 4; M2a = 6; M2c = 6. (I-L) CD31 staining indicated similar staining for endothelial cells in the different groups. Mice analyzed per group: salines = 4; M0 = 5; M2a = 5; M2c = 4. Magnification 40x with 100x insets. Graphs are quantifications of (A) NIMP, (B) F4/80 and (C) angiogenesis staining respectively. Statistical significance was evaluated analyzing M0, M2a and M2c expression levels compared to salines by t-test.CC BY · PubMed Central

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Research works printed but not linked: 1

  1. U Mirastschijski, 2002, Matrix metalloproteinase inhibitor BB-3103 unlike the serine proteinase inhibitor aprotinin abrogates epidermal healing of human skin wounds ex vivo, J Invest Dermatol, 118, 55

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Metadata

Authors
Jetten, N., Roumans, N., Gijbels, M. J., Romano, A., Post, M. J., de Winther, M. P. J., van der Hulst, R. R. W. J., & Xanthoulea, S.
Affiliations
  • Maastricht University (NL)
  • Maastricht University Medical Centre (NL)
Corresponding author
Xanthoulea, Sofia
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-07-28
Volume
9
Issue
7
Pages
e102994
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0102994
PMC
PMC4113363
OpenAlex
W2036736332
Cited by
162
References
40
Citations by year
2026: 5 · 2025: 15 · 2024: 20 · 2023: 16 · 2022: 24 · 2021: 10 · 2020: 13 · 2019: 18 · 2018: 11 · 2017: 14 · 2016: 10 · 2015: 4 · 2014: 2
FWCI
9.68
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
  • Universiteit Maastricht
  • Maastricht Universitair Medisch Centrum
Topics
  • Health Sciences › Medicine › Surgery › Wound Healing and Treatments
  • Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
  • Life Sciences › Immunology and Microbiology › Immunology › Macrophage Migration Inhibitory Factor
Keywords
M2 macrophages, macrophage polarization, skin wound healing, diabetic wounds, IL-4, IL-10, re-epithelialization, neutrophils, db/db mice, full-thickness skin wounds
MeSH terms
Animals, Diabetes Mellitus, Experimental, Disease Models, Animal, Female, Immunohistochemistry, Macrophages, Skin, Wound Healing, Gene Expression, Genes, Reporter, Mice

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